Current through March 20, 2024
Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC
16-31-3-20
Affected: IC 16-31-3; IC 16-41-10
Sec. 1.
(a) A person
shall not:
(1) furnish;
(2) operate;
(3) maintain;
(4) advertise; or
(5) otherwise engage in providing;
emergency medical services as a paramedic provider
organization unless the person is certified by the commission as a paramedic
provider organization.
(b) If the paramedic provider organization
also provides transportation of emergency patients, the paramedic provider
organization shall be certified as an ambulance service provider organization
in accordance with the requirements specified in 836 IAC 1. The paramedic
nontransport provider organizations shall meet the requirements specified in
836 IAC 1-1-5 through
836 IAC 1-1-8.
(c) The paramedic provider organization shall
ensure the following:
(1) Ambulances used are
certified and meet the requirements specified in
836 IAC 1-3.
(2) All nontransport emergency medical
services vehicles used for the provision of advanced life support meet all of
the requirements in
836 IAC 2-14.
(d) The chief executive officer of each
paramedic provider organization shall certify that the provider organization
has an agreement, or interdepartmental memo if hospital based, with one (1) or
more supervising hospitals that agree [sic] agrees to provide
the following services:
(1) Continuing
education.
(2) Audit and
review.
(3) Medical control and
direction.
(4) Provision to allow
the paramedics affiliated with the supervised paramedic provider organization
to function within the appropriate hospital department in order to obtain
continuing practice, remediation, and continuing education in their clinical
skills.
The agreement or interdepartmental memo shall include a
detailed description of how such services shall be provided to the paramedic
provider organization. In those cases where more than one (1) hospital enters
into an agreement, or seeks to enter into an agreement, with a paramedic
provider organization as a supervising hospital, the interhospital agreement
shall clearly define the specific duties and responsibilities of each hospital
to ensure medical and administrative accountability of system operation.
(e) The paramedic
provider organization shall have a medical director provided by the paramedic
provider organization or jointly with the supervising hospital. The medical
director is responsible for providing competent medical direction as
established by the medical control committee. Upon establishment of a medical
control policy, the paramedic provider organization medical director and the
chief executive officer have the duty to enact the policy within the paramedic
provider organization and accordingly enforce the policy. The duties and
responsibilities of the medical director include, but are not limited to, the
following:
(1) Provide liaison with physicians
and the medical community.
(2)
Assure that the:
(A) drugs;
(B) medications;
(C) supplies; and
(D) equipment;
are available to the paramedic provider organization.
(3) Monitor and evaluate
day-to-day medical operations of paramedic provider organizations.
(4) Assist the supervising hospital in the
provision and coordination of continuing education.
(5) Provide individual consultation to
paramedics.
(6) Participate in at
least quarterly audit and review of cases treated by paramedics of the provider
organization.
(7) Attest to the
competency of paramedics affiliated with the paramedic provider organization to
perform skills required of a paramedic under
836 IAC 4-9-5.
(8) Establish protocols for basic and
advanced life support in cooperation with the medical control committee of the
supervising hospital.
(9) Establish
and publish a list of medications, including minimum quantities and dosages to
be carried on the emergency medical services vehicle.
(10) Provide liaison between the:
(A) emergency medical service provider
organization; the [sic]
(B) emergency medical service personnel; and
the [sic]
(C)
hospital;
in regards to communicable disease testing under IC
16-41-10.
(f) The paramedic provider organization shall
maintain a communications system that shall be available twenty-four (24) hours
a day between the paramedic provider organization and the emergency department,
or equivalent, of the supervising hospital using UHF (ultrahigh frequency) or
cellular voice communications. The communications system shall be licensed by
the Federal Communications Commission.
(g) Each paramedic provider organization
shall do the following:
(1) Maintain an
adequate number of trained personnel and emergency response vehicles to provide
continuous, twenty-four (24) hour advanced life support services.
(2) Notify the commission in writing within
thirty (30) days of assigning any individual to perform the duties and
responsibilities required of a paramedic. This notification shall be signed by
the provider organization and medical director of the provider
organization.
(h) A
paramedic ambulance service provider organization must be able to provide a
paramedic level response. For the purpose of this subsection, "paramedic
response" consists of the following:
(1) A
paramedic.
(2) An emergency medical
technician or higher.
(3) An
ambulance in compliance with the requirements of section 3(e) of this
rule.
(4) During transport of the
patient, the following are the minimum staffing requirements:
(A) If paramedic level advanced life support
treatment techniques have been initiated or are needed:
(i) the ambulance must be staffed by at least
a paramedic and an emergency medical technician; and
(ii) a paramedic shall be in the patient
compartment.
(B) If an
emergency medical technician-intermediate level advanced life support treatment
techniques have been initiated or are needed:
(i) the ambulance must be staffed by at least
an emergency medical technician-intermediate and an emergency medical
technician; and
(ii) an emergency
medical technician-intermediate shall be in the patient compartment.
(C) If advanced life support
treatment techniques have not been initiated and are not needed:
(i) the ambulance must be staffed by at least
an emergency medical technician; and
(ii) an emergency medical technician shall be
in the patient compartment.
(i) For a paramedic provider organization,
when an advanced life support nontransport vehicle is dispatched for a
paramedic response, it shall, at a minimum, be staffed by a
paramedic.
(j) The paramedic
provider organization shall do the following:
(1) Notify the agency in writing within
thirty (30) days of any changes in the operation as stated in the
application.
(2) With medical
director and chief executive officer approval, allow a student or graduate of
an Indiana approved paramedic course to perform advanced life support under the
direction of a preceptor. This person shall be actively pursuing certification
as an Indiana certified paramedic. This provision shall be limited from one (1)
year from date of course completion as indicated on course report.
(3) Show proof of insurance coverage as
required by
836 IAC
1-3-6.
